Factors Associated With Strain in Carers of People With Traumatic Brain Injury

OBJECTIVE: To explore factors associated with strain in carers of patients with traumatic brain injury. DESIGN: Cross-sectional cohort study. PARTICIPANTS: Forty-eight carers of patients with traumatic brain injury admitted to a neurosurgical unit over a 9-year period were assessed an average of 9.3 years after injury. MEASURES: Caregiver Strain Index (CSI), Neurobehavioral Functioning Inventory (NFI), Glasgow Outcome Scale (GOS), Virginia Prediction Tree Score, and carer and patient demographics. PROCEDURE: Carers were assessed via postal survey for levels of strain using the CSI and for their perception of the patients' disabilities using the NFI. RESULTS: Elevated levels of strain were found in 42% of carers. Using logistic regression, outcome as rated by the patients' general practitioner on the GOS and all subscales of the NFI (except Somatic) explained 41% to 57% of the variance in strain and predicted group membership correctly in 72.9% of cases. No individual variable contributed significantly to the explained variance in the model. CONCLUSION: A number of factors appear to combine to result in feelings of strain, but the GOS could be used as a crude screening tool. Interventions for cognitive, behavioral, and emotional difficulties may be most useful for carers.